1. The study of drugs in humans is referred to as
    Clinical pharmacology
  2. The study of drugs and their interactions with living systems is the definition of
  3. Therapeutic or pharmacotherapeutics is defined as
    the use of drugs to diagnose, prevent, or treat disease or to prevent pregnancy
  4. Any chemical that can affect living processes is a
  5. the three most important characteristics that anyt drug can have are
    • effectiveness
    • safety
    • selectivity
  6. The Greek word pharmakon is translated as
  7. Some drugs interact with one another. The antibacterial effects of tetracycline can be greatly reduced by taking??
    iron or calcium supplements
  8. The objective of drug therapy is to provide
    maximum benefit with minimum harm
  9. The four major pharmacokinetic processes are
    • drug absorption
    • drug distribution
    • drug metabolism
    • drug excretion
  10. Pharmacodynamics may be thought of as
    the impact of drugs on the body
  11. What are the five rights of drug administration
    • right drug
    • right patient
    • right dose
    • right route
    • right time
  12. Who is the most likely member of the health care team to observe and evaluate drug responses and to intervene if required??
    The Nurse
  13. the three basic goals of preadministration assessment of medications are
    Collecting baseline data needed to evaluate therapeutic and adverse responses, identifying high risk patients, assessing the patients capacity for self care
  14. Important predisposing factors in identifying high risk patients are
    • pathophysiology
    • genetic factors
    • drug allergies
    • pregnancy
    • old age
    • extreme youth
  15. Certain drugs have more thaqn one indication, and the dosage may differ depending on the indication for which the drug is used. Aspirin is given in low doses to
    relieve pain and in high doses to suppress inflammation
  16. Measures to reduce adverse effects of medication administration include
    • identifying high risk patients through the patient history
    • ensuring proper administration through patient education
    • forewarning patients about activities that might precipitate an adverse reaction
  17. Patients taking insulin therapy should be taught that early signs of hypoglycemia include
    sweating and increased heart rate
  18. Contraindication (or Precaution)
    a pre-existing condition that significantly increases the risk of an adverse reaction to a particular drug, but not to a degree that is life threatening
  19. Among geriatric patients, the most common cause of failed self medication is
    Conviction that the drug simply was not needed in the dosage prescribed
  20. A harmless side effect of rifampin is
    red-orange color to urine
  21. the first legislation to regulate drug safety passed in 1938 was the
    Food, Drug and Cosmetic Act
  22. This law was created in response to the thalidomide tragedy that occurred in Europe in the early 1960's
    Harris-Kefauver Amendments
  23. the first American law to regulate drugs was the
    Federal Pure Food and Drug Act of 1906
  24. In the early 1960's thalidomide was widely used by pregnant women, and thousands of infants were born with ???
  25. Phocomelia
    a rare birth defect characterized by the gross malformation or complete absence or arms or legs
  26. Under conditions of the controlled substance Act, schedule I drugs
    Have no medical use in the United States and are deemed to have a high potential for abuse
  27. In the United States, the estimated cost of developing a new drug can exceed
    800 million dollars
  28. Randomized controlled trials are
    the most reliable way to objectively assess drug therapies
  29. Phase I drugtrials are usually conducted in
    normal volunteers
  30. Phase II and Phase III trials are tested in
  31. The chemical name constitutes
    a description of a drug using the nomenclature of chemistry
  32. The Generic name
    is assigned by the U.S. Adopted Names Council
  33. The Trade name, Proprietary name, and Brand names are names
    under which a drug is marketed
  34. Drugs that can be purchased without a prescription are referred to as
    Over the counter drugs
  35. Pharmacokinetics
    The study of drug movement through the body
  36. In order for a drug to directly penetrate membranes, it must be
    Lipid soluble
  37. Factors that affect drug absorption iclude
    • rate of dissolution
    • surface area
    • blood flow
    • lipid solubility
    • pH partitioning
  38. Enteric-coated preparations
    consist of drugs that have been covered with a material designed to dissolve in the intestine but not the stomach
  39. Most dug metabolism take place in the
  40. Nonrenal routes of drug excretion include
    • breast milk
    • bile
    • enterohepatic recirculation
    • lungs
    • sweat
    • saliva
  41. Three procedures that can be employed to reduce fluctuations in drug levels are
    • Continuous infusion
    • administration of a depot preparation
    • reduction of both the dosage size and dosing interval
  42. The therapeutic range of a drug lies between the
    minimum effective concentration and toxic concentration
  43. Most drugs are excreted by the
  44. Oral administration of medications has the advantages of
    • Ease
    • convenience
    • inexpensive
  45. Pharmacodynamics
    the study of the biochemical and physiologic effects of drugs and the molecular mechanisms by which those effects are produced
  46. The greatest effect a drug can produce is called the
    maximal efficacy
  47. Potency
    refers to the amount of drug we must give to elicit and effect
  48. A Receptor
    any functional macromolecule in a cell to which a drug binds to produce its effects.
  49. The function of the transcription factors is to
    regulate protein synthesis
  50. The modified theory ascribes two qualities to drugs
    Affinity and intrinsic activity
  51. Affinity refers to the
    Strength of the attraction between a drug and its receptor
  52. And intrinsic activity refers to
    the ability of a drug to activate a receptor upon binding
  53. Drugs that mimic the body's regulatory molecules are called
  54. Drugs that block the actions of endogenous regulators are called
  55. When the receptors of a cell are continually exposed to an agonist, the cell usually becomes less responsive, the cell is said to be
    desensitized or refractory or to have undergone down- regulation
  56. The four primary families of receptors are
    • cell membrane-embedded enzymes
    • ligand-gated ion channels
    • G protein-coupled receptor systems
    • transcription factors
  57. The therapeutic index is defined as
    the ratio of a drug's LD50 to its ED50
  58. Patients receiving both halothane and succinylcholine may develop
    malignant hyperthermia
  59. Three possible outcomes that may occur when drug A interacts with Drug B are:
    • Drug A may intensify the effects of drug B
    • Drug A may reduce the effects of drug B
    • the combination of drug A and drug B may produce a new response no seen with either drug alone
  60. When a patient is taking two medications and one drug may intensify the effects of the other, the interaction is termed
  61. Interactions that result in reduced drug effects are often termed
  62. Direct interactions are most commonly found when drugs are combined
    in IV solutions
  63. Interactions are especially important for drugs that have a
    low therapeutic index
  64. Some foods cause decreased absorption of drugs. Absorption of digoxin is significantly reduced by
    • Wheat bran
    • Rolled oats
    • Sun flower seeds
  65. The most dramatic example of drug-food interactions that sometimes increase toxicity is the interaction between
    • Monoamine oxidase inhibitors (a family of antidepressants),
    • Foods rich in tyramine (aged cheese, yeast extracts, Chianti)
  66. Any noxious, unintended, and undesired effect that occurs at normal drug doses is defined by the World Health Organization as an
    Adverse drug reaction
  67. Mild adverse drug reactions include
    • Drowsiness
    • nausea
    • itching
    • rash
  68. Severe reactions include
    • respiratory depression
    • neutropenia
    • hepatocellular injury
    • anaphylaxis
    • hemorrhage
  69. Mide adverse and Severe reactions can both result in
  70. A side effect is formally defined as
    A nearly unavoidable secondary drug effect produced at therapeutic doses
  71. Toxicity
    an adverse drug reaction caused by excessive dosing
  72. Mos serious reactions are caused by one group of drugs
  73. Other drugs are noted for causing allergic reactions including the
    sulfonamide group of compounds
  74. An uncommon drug response resulting from a genetic predisposition is called an
    idiosyncratic effect
  75. A disease caused by a drug is called an
    iatrogenic disease
  76. A state in which the body has adapted to prolonged drug exposure in such a way that an abstinence syndrome will result if drug use is discontinued is known as
    Physical dependence
  77. Drug-induced birth defects are referred to as
    teratogenic effects
  78. The patient's last line of defense against medication errors made by others is the
  79. Dosage adjustments based on adverse drug reaction provide
    more precise means of controlling drug responses than do adjustments based on weight alone
  80. Drug sensitivity varies with age. In infants
    heightened drug sensitivity is the result of organ immaturity
  81. In the Elderly, heightened sensitivity results largely from
    organ degeneration
  82. Why do we not know much about gender-related differences in drug therapy
    because until recently, essentially all drug research was done in men
  83. Perhaps the most important example of an altered drug effect occurring in response to electrolyte imbalance involves digoxin and
  84. Decreased responsiveness to a drug, as a result or repeated drug administration is called
  85. The type of tolerance associated with long-term administration of drugs such as morphine and heroin is
    pharmocodynamic tolerance
  86. A form of tolerance that can be defined as a reduction in drug responsiveness brought on by repeated dosing over a short time is called
  87. Placebo effect
    a component of a drug response that is caused by psychologic factors and not by the biochemical or physiologic properties of the drug
  88. Bioavailability
    refers to the ability of a drug to reach the systemic circulation from its site of administration
  89. Some factors that influence patient compliance include
    • manual dexterity
    • visual acuity
    • intellectual capacity
    • psychologic state
    • attitude toward drugs
    • the ability to pay for medications
  90. By the third trimester, renal blood flow in the pregnant woman has
  91. Is it true that drugs taken by the mother do no cross the placenta??
    No; any drug taken during pregnancy will reach the fetus
  92. Teratogensis
    the production of birth defects
  93. symptoms of withdrawal syndrome in the infant include
    • shrill crying
    • vomiting
    • extreme irritability
  94. Down's syndrome
    of the genetically based anomalies is it is the most common
  95. Gross malformations are produced by exposure to teratogens during the
    Embryonic period
  96. Teratogen exposure during the
    Fetal period; usually disrupts the function rather than gross anatomy
  97. The teratogen Diethylstilbestrol is an
    estrogenic substance that causes vaginal cancer in female offspring 18 o so years after birth
  98. An example of a functional impairment that results from exposure to teratogen later in pregnancy is
    Mental retardation
  99. Drug sensitivity in the very young results largely from
    Organ system immaturity
  100. Drug sensitivity in the elderly results largely from
    Organ system degeneration
  101. The pediatric age group includes all patients younger than
    16 years of age
  102. Premature infants
    Less than 36 weeks gestational age
  103. Full-term infants
    36-40 weeks gestational age
  104. neonates
    first 4 postnatal weeks
  105. infants
    weeks 5 to 52 postnatal
  106. children
    1 to 12 years
  107. adolescents
    12 to 16 years
  108. how do drugs affect the blood-brain barrier of the infant?
    because the blood-brain barrier is not fully developed at birth, drugs and other chemicals have relatively easy access to the central nervous system, making the infant especially sensitive to drugs that affect the CNS.

    All medications employed for their CNS effects should be given in reduced dosages
  109. Complete maturation of the liver is accomplished by age
    1 year
  110. Adult levels of renal function are achieved by age
    1 year
  111. In the pediatric population, adverse drug reactions to fluoroquinolones may cause
    tendon rupture
  112. Adverse drug reactions to nalidxic acid may cause
    cartilage erosion
  113. Children 1 to 12 years of age differ pharmacokinetically from adults in that children metabolize drugs
  114. The method of conversion of adult dosages of drugs to pediatric dosages of drugs employed most commonly is based on
    Body surface area
  115. The four major factors that can alter drug distribution in the elderly include
    • Increased percentage of body fat
    • decreased percentage of lean body mass
    • decreased total body water
    • reduced concentration of serum albumin
  116. The most important cause of adverse drug reactions in the elderly is
    drug accumulation secondary to reduced renal excretion
  117. In the elderly the proper index of renal function is
    Creatinine clearance
  118. Factors underlying the increase in adverse reactions in the geriatric population include
    • polypharmacy
    • severe illness
    • multiple pathologies
    • treatment with dangerous drugs
  119. Neuropharmacology
    the study of drugs that alter processes controlled by the nervous system
  120. Most neuropharmacologic agents act by altering
    Synaptic transmission

    only a few alter axonal conduction
  121. What are the only drugs that are proven to work by altering or decreasing axonal conduction??
    Local anesthetics
  122. A drug with effects that mimic the effects of a natural transmitter would be said to
    increase receptor activation
  123. A drug with effects that are equivalent to reducing the amount of natural transmitter available for receptor binding would be said to
    Decrease receptor activation
  124. What is the effect of botulinum toxin
    Botulinum toxin blocks the release of acetylcholine from the neurons that control skeletal muscles, including the muscles of respiration

    Loss of function of the respiratory muscles and suffocation occur
  125. The most prominent responses to activation of beta 1 receptors are
    increased heart rate and increased force of cardiac contraction
  126. The primary responses to activation of beta 2 receptors are
    Bronchial dilation and elevation of glucose levels in the blood
  127. Drugs that increase receptor activation are called
    Agonist drugs
  128. Drugs that decrease receptor activation are called
    Antagonist drugs
  129. When you study each drug that has an effect on the peripheral nervous system you should learn
    the identity of the receptors at which the drug acts

    the normal responses to activation of those receptors

    whether the drug increases or decreases receptor activation
  130. The peripheral nervous system has two major subdivisions
    Somatic motor system

    Autonomic nervous system
  131. The autonomic nervous system has three principal functions
    • Regulation of the heart
    • Regulation of the secretory glands
    • Regulation of smooth muscle
  132. By influencing the heart and blood vessels, the sympathetic nervous system can achieve three homeostatic objectives
    • 1. Maintenance of blood flow to the brain
    • 2. Redistribution of blood flow during exercise
    • 3. Compensation for loss of blood, primarily causing vasoconstriction
  133. From a pharmacologic perspective, the most important feedback loop of the autonomic nervous system is one that helps regulate blood pressure. It is referred to as the
    Baroreceptor reflex
  134. The three neurotransmitters employed by the peripheral nervous system are
    • Acetylcholine
    • Norepinephrine
    • Epinephrine
  135. Activation of nicotinic (muscle) causes
    Contraction of skeletal muscle
  136. Activation of alpa receptors in the blood vessels produces
  137. The release of renin promotes
    Synthesis of angiotensin, a powerful vasoconstrictor;

    Activation of renal beta1 receptors is a means by which the nervous system helps elevate blood pressure
  138. Epinephrine is released from the
    Adrenal medulla
  139. Epinephrine's function is to
    initiate the fight or flight response
  140. Activation of beta 1 receptors
    • Increase the heart rate
    • Increase the force of myocardial contraction
    • Increases conduction through the Av node (promotes release of renin by the kidney)
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